University of Pisa, Italy
Silvia Strambi is a Post-graduate Pediatric Surgery student and a Scientific Consultant of Department of Surgical, Medical, and Molecular Pathology and of the Critical Area of University of Pisa (Italy). She is actively involved in clinical care and surgery, as well as in research activities. Her studies have materialized to date in 15 published articles, 9 conference abstracts and 2 books; 1 of them, about sexual development disorders, as author. She has personally presented, as speaker, the results of her original researches in 2 Italian and 4 international conferences.
The aim of this study is to carry out a comparison of n-butyl-cyanoacrylate plus MS monomer (NBCA-MS) versus suture in pediatric circumcision. 100 boys (age 18 months-14 years) were prospectively randomized in two groups: In 50 boys the wound margins were approximated by NBCA-MS glue while in other 50 boys interrupted polyglycolic acid 5-0 stitches were used. After surgery, 25 patients of each group (subgroup A) received 6 days of Amoxicillin/clavulanic acid and Neomycin sulfate cream, while the other 25 (subgroup B) did not receive any post-operative therapy. Wound was checked on 7th postoperative day to evidence potential infection or other complications, while resultant scar was examined 30 and 180 days after surgery for assessment of cosmetic outcome. Operative time, pain score, infective complications and cosmesis were statistically evaluated. Operative time was significantly higher in the suture group. Pain severity and duration were less in the glue group but not significantly different. In the glue group, no complications occurred, while the suture group presented 7 (14%) cases of postoperative edema and 5 (10%) cases of infection (in subgroup B). The incidence of infection in suture group as compared to glue group was statistically significant. Cosmetic results were significantly better in the glue group after 1 and 6 months follow-up. NBCA-MS glue is confirmed to be a safe and effective alternative for wound approximation in pediatric circumcision.